NPIMap

Organization Active NPI

Cooper Optometry

  • Optometrist
  • Santa Monica, CA
National Provider Identifier
1083069777
Registry record updated Apr 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
14440TLG Issued in CA
Legal business name
COOPER OPTOMETRY
Practice address
2730 Wilshire Blvd
Ste 545
Santa Monica, CA 90403-4743
Phone
(310) 315-9122
Fax
(310) 315-9122
NPI assigned
Apr 29, 2016
Last updated
Apr 29, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Donna Cooper, ODNPI 1528321056
Title
Owner
Phone
(949) 584-6417

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 14440TLG CA Primary

Addresses

Primary practice location

2730 Wilshire Blvd
Ste 545
Santa Monica, CA 90403-4743

Mailing address

2730 Wilshire Blvd
Ste 545
Santa Monica, CA 90403-4743
Phone (310) 315-9122

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160822000804 CA Part B Supplier - Clinic/Group Practice 0345535928 Receives reassigned benefits from 2 practitioners
Practice locations: Santa Monica, CA

National Provider Directory

National Provider Directory

Locations

2730 Wilshire Blvd
Ste 545
Santa Monica, CA 90403
Phone (310) 315-9122

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1461888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461888000000",
    "number": "1083069777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2730 WILSHIRE BLVD",
            "address_2": "STE 545",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904034743",
            "telephone_number": "310-315-9122",
            "fax_number": "310-315-9122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2730 WILSHIRE BLVD",
            "address_2": "STE 545",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904034743",
            "telephone_number": "310-315-9122",
            "fax_number": "310-315-9122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOPER OPTOMETRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-29",
        "last_updated": "2016-04-29",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-584-6417",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14440TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.